Dr. Gerald Bloomfield is a cardiology fellow-in-training at Duke University. The candidate's long-term interest is to become a clinical researcher in the epidemiology and treatment of chronic cardiovascular disease (CVD) in the developing world, thereby improving the health of the disadvantaged using primary and secondary prevention methods. The proposed career development plan incorporates a multi-disciplinary program designed to provide an intense, closely mentored, patient-oriented research experience in association with a comprehensively structured didactic curriculum in biostatistics and epidemiology. Under the mentorship of Dr. John A. Bartlett (Duke Global Health Institute), Dr. Bob Harrington (Duke Clinical Research Institute, DCRI), Dr. Fabian Esamai (Moi University School of Medicine, Kenya) and Dr. Thomas Gaziano (Harvard University School of Public Health), Dr. Bloomfield will employ a case-control research design in Kenyan patients with and without heart failure (HF). Using modern echocardiography, serologic assays and clinical assessments, our specific aims are to identify and describe the taxonomies of heart failure in a Kenyan Tertiary Referral University clinic with special emphasis on ischemic heart disease, to describe the prevalence of subclinical atherosclerosis among patients with heart failure and to describe the prevalence of modifiable and non-modifiable risk factors for atherosclerosis among patients with heart failure. By spending one year with the Moi University School of Medicine in Kenya performing this project, we hope to collect pilot data on the burden of atherosclerosis among patients with heart failure;thereby informing hypotheses for larger prospective, regionally-relevant analyses in the future. Dr Bloomfield will also mentor aspiring Kenyan clinical researchers and facilitate portions of a clinical research training program. The candidate will have at his disposal the infrastructure, patient population and statistical support of the American/Sub Saharan African Network for Training and Education (ASANTE) consortium based in Eldoret, Kenya whose members include Moi University, Indiana University, Brown University and Duke University. In years 2 and beyond, Dr. Bloomfield will take part in the DCRI clinical research training program, experience first-hand the featutes of conducting international clinical trials, attend weekly research conferences, present abstracts at national.conferences and draft manuscripts. PUBLIC HEALTH RELEVANCE: As the landscape of CVD in Sub-Saharan Africa (SSA) shifts from communicable to chronic, degenerative diseases, the economic and human costs will significantly challenge the region. Understanding the modern etiologies of HF and prevalence of atherosclerosis in SSA are important so that we can implement relevant preventive strategies, create locally pertinent long-term registries and appropriately train a cadre of Kenyan clinician investigators to lead this effort in the future.